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\begin{document}

\title{Angioplasty balloon occlusion of LIMA graft in reoperations of patients
with prosthetic valve endocarditis and patent LIMA-LAD graft}



\author[1]{Ivilin Todorov}%
\author[2]{Zdravka P. Todorova}%
\author[1]{Dimitar P. Nikolov}%
\affil[1]{Department of cardiothoracic surgery Acibadem City Clinic Tokuda Hospital Sofia Bulgaria}%
\affil[2]{Medicinski universitet-Sofia}%


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  \date{May 21, 2024}


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\begin{abstract}
\emph{Background}: Myocardial protection in reoperations in cardiac
surgery is extremely difficult in patients with previous coronary
surgery and a working LIMA-LAD graft, and it largely determines the
outcome of surgery and long-term prognosis. We use a the method of
percutaneous angiographic balloon LIMA occlusion and cardioplegic
arrest. \emph{Aims:} The aim of this study was to compare the data of
patients with angiographic balloon LIMA-occlusion and those without
occlusion in operations related to PVE, and previous coronary surgery
with permeable LIMA graft, determining the degree of safety and benefits
of method. \emph{Study design and Methods:} A total of 20 patients
undergoing surgery for prosthesis valve endocarditis with patent
LIMA-LAD graft were analyzed retrospectively. We divide the patients
into 2 groups. Group A patients - with LIMA occlusion and Group B
patients - without LIMA occlusion). The pre-, intra- and postoperative
results were compared and the degree of safety and benefits of the
application of the method were studied. \emph{Results:} 80\% of patients
in group A needed only dopamine infusion and 20\% needed the addition of
a second catecholamine (Adrenaline) at the end of CPB. In group B, the
need for double catecholamine maintenance is in 50\% of patients. The
need for implantation of an intra-aortic balloon pump due to refractory
heart failure was registered in 10\% of patients in group A and in 20\%
of patients in group B. It was found that the average duration of
mechanical ventilation in group A is 10.5 hours postoperatively, and in
group B - 12.5 hours. The mean duration of catecholamine infusion in
both groups was 3 days. The average stay in intensive care is shorter
for patients in Group A - 2.5 days, and in Group B is 3.5 days. In terms
of survival - mortality in the group with LIMA occlusion is 0\%, while
in the group without LIMA occlusion is 20\%. \emph{Conclusion:} Our
reported results from the use of the LIMA balloon occlusion method in
patients with prosthetic valve endocarditis who are high-risk and
complicated patients and nevertheless the mortality in this group
studied by us is 0\% and no serious complications of the applied method
have been registered. Therefore, we believe that the angiographic
balloon LIMA occlusion is a reliable, easily applicable and relatively
safe technique that improves the surgical results and prognosis of
patients in need of reoperative cardiac surgery.%
\end{abstract}%



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\textbf{Hosted file}

\verb`Angioplasty balloon occlusion of the LIMA graft in patients with PVE.docx`  available at \url{https://authorea.com/users/450158/articles/548544-angioplasty-balloon-occlusion-of-lima-graft-in-reoperations-of-patients-with-prosthetic-valve-endocarditis-and-patent-lima-lad-graft}

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